Delhi Journal of Ophthalmology

A Case of Recurrent Vasculitic Vitreous Haemorrhage in One Eye and Idiopathic Choroidal Granulomas in The Fellow Eye of A Young Individual

Himanshi Aggarwal, Prateek Nishant, Gitanjli Sood, Achala Ramawat, Ajai Agrawal, Sanjeev Kumar Mittal, Ramanuj Samanta
Department of Ophthalmology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India

Editor-in-Chief, Delhi Journal of Ophthalmology, Dr R.P.Centre, AIIMS.


Corresponding Author:

Ramanuj Samanta (MS)
Assistant Professor
Department of Ophthalmology
All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
Email : ramanuj.samanta@gmail.com


Received: 08-JUN-2020 Accepted: 21-JUL-2020 Published Online: 09-JUL-2021
DOI: https://dx.doi.org/10.7869/djo.665

Abstract
A 26-year-old male presented with sudden diminution of vision in right eye (OD) for 15 days. Best-corrected visual acuity (BCVA) was finger counting 1-metre in OD and 6/6 in left eye (OS). Fundus examination revealed fresh vitreous haemorrhage (VH) in OD. Investigations including complete haemogram, VDRL, Mantoux test and Contrast-Enhanced Computed Tomography chest were normal. A presumptive diagnosis of Eales disease was made. Subsequently he also developed multiple small choroidal granulomas in OS. He was started on oral corticosteroid and treated with multiple episodes of scatter-laser and intravitreal bevacizumab in OD for recurrent VH. He ultimately required pars-plana vitrectomy in OD for persistent VH despite anti-VEGF and laser. Choroidal granulomas in OS disappeared after treatment with oral steroid. He maintained BCVA of 6/6 in both eyes after 6-months and was kept under close follow-up. Multimodal approach and combination modality of treatment may be required for optimal outcome in such cases.

Keywords :Eales Disease, Retinal Vasculitis, Pars Plana Vitrectomy, Vitreous Haemorrhage, Anti-Vegf